|
HC TRANSCATH RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
OP
|
$8,854.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,287.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,230.94
|
| Rate for Payer: BCBS Transplant Transplant |
$5,312.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: Cigna of CA PPO |
$6,551.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,640.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,312.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,312.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,427.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,427.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,427.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,427.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
OP
|
$8,854.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,287.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,230.94
|
| Rate for Payer: BCBS Transplant Transplant |
$5,312.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: Cigna of CA PPO |
$6,551.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,640.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,312.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,312.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,427.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,427.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,427.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,427.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
IP
|
$8,854.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$7,968.60 |
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,541.60
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
IP
|
$8,854.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$7,968.60 |
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,541.60
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
OP
|
$8,854.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,287.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,230.94
|
| Rate for Payer: BCBS Transplant Transplant |
$5,312.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: Cigna of CA PPO |
$6,551.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,640.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,312.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,312.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,427.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,427.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,427.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,427.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
OP
|
$54,122.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,205.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,975.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$32,473.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: Cigna of CA PPO |
$40,050.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40,591.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32,473.20
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,473.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,061.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,061.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
IP
|
$54,122.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,824.40 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,648.80
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
OP
|
$54,122.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,205.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,975.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$32,473.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: Cigna of CA PPO |
$40,050.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40,591.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32,473.20
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,473.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,061.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,061.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
IP
|
$54,122.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,824.40 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,648.80
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
IP
|
$54,122.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,824.40 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,648.80
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
OP
|
$54,122.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,205.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,975.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$32,473.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: Cigna of CA PPO |
$40,050.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40,591.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32,473.20
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,473.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,061.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,061.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH RMVL REPL SC LEADLESS PMKR RA
|
Facility
IP
|
$54,122.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,824.40 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,648.80
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
|
|
HC TRANSCATH RMVL REPL SC LEADLESS PMKR RA
|
Facility
OP
|
$54,122.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,417.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,205.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,975.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$32,473.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: Cigna of CA PPO |
$40,050.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40,591.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32,473.20
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,473.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,061.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,061.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH RMVL SC LEADLESS PMKR RA
|
Facility
IP
|
$8,854.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$7,968.60 |
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,541.60
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
|
|
HC TRANSCATH RMVL SC LEADLESS PMKR RA
|
Facility
OP
|
$8,854.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,770.80 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,287.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,230.94
|
| Rate for Payer: BCBS Transplant Transplant |
$5,312.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Cash Price |
$3,984.30
|
| Rate for Payer: Central Health Plan Commercial |
$7,083.20
|
| Rate for Payer: Cigna of CA PPO |
$6,551.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$7,525.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,312.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,968.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,640.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,905.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,770.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,640.50
|
| Rate for Payer: Networks By Design Commercial |
$5,755.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,525.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,312.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,312.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,427.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,427.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,427.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,427.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
IP
|
$24,728.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,945.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
OP
|
$24,728.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$22,255.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,018.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13,600.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,600.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$14,836.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: Cigna of CA PPO |
$18,298.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,018.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18,546.00
|
| Rate for Payer: IEHP medi-cal |
$8,654.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14,836.80
|
| Rate for Payer: Riverside University Health MISP |
$9,891.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,836.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,018.80
|
| Rate for Payer: Vantage Medical Group Senior |
$21,018.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
OP
|
$24,728.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906820293
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$22,255.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,018.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13,600.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,600.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$14,836.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: Cigna of CA PPO |
$18,298.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,018.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18,546.00
|
| Rate for Payer: IEHP medi-cal |
$8,654.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14,836.80
|
| Rate for Payer: Riverside University Health MISP |
$9,891.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,836.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,018.80
|
| Rate for Payer: Vantage Medical Group Senior |
$21,018.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
IP
|
$24,728.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906820293
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,945.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
IP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
OP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906820133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,975.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,734.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,734.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,995.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,093.36
|
| Rate for Payer: BCBS Transplant Transplant |
$5,164.80
|
| Rate for Payer: Blue Shield of California Commercial |
$5,319.74
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.49
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: Cigna of CA HMO |
$5,509.12
|
| Rate for Payer: Cigna of CA PPO |
$6,369.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,456.00
|
| Rate for Payer: IEHP medi-cal |
$3,012.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: Riverside University Health MISP |
$3,443.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,164.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,304.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,304.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,304.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
IP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906820133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
OP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,975.81
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,734.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,734.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,995.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,093.36
|
| Rate for Payer: BCBS Transplant Transplant |
$5,164.80
|
| Rate for Payer: Blue Shield of California Commercial |
$5,319.74
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.49
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: Cigna of CA HMO |
$5,509.12
|
| Rate for Payer: Cigna of CA PPO |
$6,369.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,456.00
|
| Rate for Payer: IEHP medi-cal |
$3,012.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: Riverside University Health MISP |
$3,443.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,164.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,304.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,304.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,304.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.80
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906820273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$22,924.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,246.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14,009.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,283.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Central Health Plan Commercial |
$20,377.60
|
| Rate for Payer: Cigna of CA PPO |
$18,849.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,188.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,188.80
|
| Rate for Payer: Galaxy Health WC |
$21,651.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15,283.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,924.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,104.00
|
| Rate for Payer: IEHP medi-cal |
$8,915.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,989.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,094.40
|
| Rate for Payer: Multiplan Commercial |
$19,104.00
|
| Rate for Payer: Networks By Design Commercial |
$16,556.80
|
| Rate for Payer: Prime Health Services Commercial |
$21,651.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,283.20
|
| Rate for Payer: Riverside University Health MISP |
$10,188.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,283.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21,651.20
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$22,924.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,246.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14,009.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,283.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Central Health Plan Commercial |
$20,377.60
|
| Rate for Payer: Cigna of CA PPO |
$18,849.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,188.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,188.80
|
| Rate for Payer: Galaxy Health WC |
$21,651.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15,283.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,924.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,104.00
|
| Rate for Payer: IEHP medi-cal |
$8,915.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,989.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,094.40
|
| Rate for Payer: Multiplan Commercial |
$19,104.00
|
| Rate for Payer: Networks By Design Commercial |
$16,556.80
|
| Rate for Payer: Prime Health Services Commercial |
$21,651.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,283.20
|
| Rate for Payer: Riverside University Health MISP |
$10,188.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,283.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21,651.20
|
|
